Monday, April 11, 2011

One for the road.

My mother, bless her little cotton socks, is convinced that I'm an alcoholic, that alcohol is evil and destroys lives. It makes for interesting conversations sometimes. It's something that would probably make me pay a lot more attention to the research done on the effects of alcohol - at both a societal and individual level - even if I wasn't already quite interested in the production of and the effects of consumption. My current line of thought, given New Zealand's somewhat unhealthy relationship with alcohol is that it should be expensive. Price controls are crude tool that affects lower socioeconomic groups more than the higher ones. Given that most of the population is not rolling in money though, it seems like it could be reasonably effective. The best course of action of course, would be to change the country's attitude to alcohol, but I don't quite see how we go about it.

Anyway. In the spirit of giving me something to think about, a bunch of chaps and chapettes from Helsinki crunched some numbers after the country cut an average of 33% off the taxes on various alcohols when next door neighbor Estonia joined the EU. They came up with this. They collected cause of death data from Statistics Finland and broke it down by age group. They then looked at alcohol related deaths - deaths either directly caused by alcohol such as alcohol poisoning or alcohol attributable disease like cirrhosis of the liver or deaths that had alcohol as an as a related factor such as accidents or suicide. They corrected their data for seasonal variations in the death rate and then looked at mortality in the years before and after the price cuts. They're up front about the problems inherent in using alcohol sales as a measure of consumption - the fact that it doesn't take into account binge vs normal drinking. Though given the Finns ability to figure out who died from alcohol poisoning, I imagine the data is somewhere for the amount of alcohol consumed, combined that with hospital admissions for overdoses and the like, factors like that could be dealt with. At this stage though, I think sales is a sufficiently accurate metric.

So what did they find? There are a few age groups (males 40-49, male and female 50-69) where the price reduction resulted in an increase in alcohol related mortality. There was essentially no change in the younger groups and a decrease in alcohol related mortality for women 40-49 and people over 70 in general. It's intriguing, neither the increases or decreases were huge. It doesn't pretend to look at other effects of alcohol on society. In terms of alcohol's ability to kill however, it's interesting. It will be interesting to see what the long term trends tend to be in Finland - especially if they can teases out with a little more detail the causes of the decrease in mortality rates in the older generations. If we're lucky it could help us understand what it is that alcohol does that is good for us. Like a lot of things, it's not good or evil, it's how we use it.

Herttua, K., Makela, P., & Martikainen, P. (2009). An evaluation of the impact of a large reduction in alcohol prices on alcohol-related and all-cause mortality: time series analysis of a population-based natural experiment International Journal of Epidemiology, 40 (2), 441-454 DOI: 10.1093/ije/dyp336